gms | German Medical Science

Background: Restricted access to rehabilitative care may affect the participation of people with chronic diseases. Our analyses therefore examined the extent to which medical rehabilitation requests decreased due to the pandemic.

Methods: Our data represented all medical rehabilitation claims in 2019 and 2020. We used a difference-in-differences model to determine the reduction in rehabilitation requests attributable to the pandemic.

Results: We included 1,621,840 rehabilitation requests in 2019 and 1,391,642 rehabilitation requests in 2020. The number of medical rehabilitation requests decreased by 14.5% due to the pandemic (incidence rate ratio, IRR = 0.855; 95% CI: 0.851 to 0.859). The decline in requests was more pronounced among women and in Western Germany than among men and in Eastern Germany. The reduction in requests affected non-post-acute rehabilitations more clearly than post-acute rehabilitation services. After the pandemic declaration by the German Bundestag in March 2020, the reduction in requests was initially highly associated with the regional incidence of infection. This association weakened in the following months.

Conclusion: The reduction in requests will have a significant impact on the number of completed rehabilitation services. For many people with chronic diseases, failure to provide medical rehabilitation increases the risk of disease progression. The economic situation of medical rehabilitation centers is expected to worsen after an already difficult 2020.